Anderson, Jean

Anderson, Jean is an sole proprietor health care provider with primary practice located at 552 Fagaima Road , Pago Pago AS 96799. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Anderson, Jean can be contacted via phone (684) 252-7455.

Contact Information

Primary practice address
552 Fagaima Road Pago Pago AS 96799
Phone: (684) 252-7455
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4047-A American Samoa

Profile Details

NPI number 1366824096
LBN Legal business name Anderson, Jean
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2015
Last updated Jun 18th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366824096 NPPES
American Samoa Other 4047-A HEALTH REGULATORY BOARD LICENSE

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